A health care worker's hands are the main route infections take to move from one patient to another. A recent study of several intensive care units—where a patient's vulnerability to infection is the highest—showed that hands were washed on only one quarter of the necessary occasions. To combat this issue, hospitals are implementing numerous strategies to promote hand-washing and, moreover, to monitor compliance with hand-washing directives and guidelines. Such directives and guidelines include, for example, the World Health Organization's (WHO) “Hand Hygiene Guidelines in Health Care” (the “WHO Guidelines”) that describe best practices for hand-washing and other hygiene events. See, e.g., http://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf). Furthermore, the newly developed “Five Moments for Hand Hygiene” have emerged from the WHO guidelines, which adds value to any hand hygiene improvement strategy. Quite simply, the WHO guidelines define five key moments for hand hygiene, overcoming misleading language and complicated descriptions. Moreover, the WHO guidelines present a unified vision and promote a strong sense of ownership. Indeed, not only do the “Five Moments” align with the evidence base concerning the spread of healthcare-acquired illnesses, but it is interwoven with the natural workflow of care. Advantageously, the WHO guidelines and the “Five Moments” are designed to be easy to learn, logical, and applicable in a wide range of settings.
The first of the “Five Moments” for hand hygiene occurs before patient contact, e.g., before shaking a patient's hand, before helping a patient move around, before a clinical examination, and so forth. The second of the “Five Moments” occurs before any aseptic task, e.g., before performing oral/dental care, before secretion aspiration, before wound dressing, before catheter insertion, before preparation of food or preparation of medicine, and so forth. The third of the “Five Moments” occurs after a body fluid exposure risk, e.g., after oral/dental care, after secretion aspiration, after drawing and manipulating blood, after clearing urine or feces, after handling wastes, and so forth. The fourth of the “Five Moments” occurs after patient contact, e.g., after shaking a patient's hand, after helping a patient move around, after a clinical examination, and so forth. The fifth of the “Five Moments” occurs after contact with patient surroundings, e.g., after changing bed linens, after perfusion speed adjustment, and so forth.
Notwithstanding, it is rare to find a hospital that has been able to maintain a hand-washing rate above 50 percent. Compliance can only improve if hospitals monitor which of its health care workers (HCWs) is or is not cleaning his/her hands; under what circumstances the HCW is performing hand-washing activity; and whether or not the HCW is performing hand-washing activity correctly, e.g., for a pre-designated length of time, for those particular circumstances. Moreover, individual doctors and nurses need to know his/her own hand-washing rates, and these data need to be easy to collect and analyze.
Although the “Five Moments” look good on paper, there are currently no methods that exist for monitoring compliance with these suggested practices beyond visual observation of healthcare workers. Moreover, there is a need for a method for electronically monitoring hand hygiene and, more particularly, electronically monitoring compliance with all five of the “Five Moments.” Prior art systems and methods for providing automated hand-washing monitoring and for verifying compliance of hand-washing activity have focused on certain features or devices that are inherent to the systems. Unfortunately, these features and devices merely serve as surrogates for the hand-washing activity itself Some of the prior art focuses on the dispensing device (“dispenser”) and/or the dispensing act in which a hand-washing agent, liquid, solution and the like is dispensed ostensibly unto a HCW's hands. For example, U.S. Pat. No. 7,855,651 to LeBlond, et al. and U.S. Pat. No. 8,094,029 to Ortiz, et al. focus on the dispenser and, more specifically, record the number of times each dispenser is used by the entire HCW population. Disadvantageously, the system and method account for a general population rather than look at a discrete individual or practice group. Furthermore, both patents further rely on a “globally accepted human observation method” to determine, first, the number of hand hygiene opportunities during a desired, pre-determined, and/or specified period of time; and, second, to compute a Hand Hygiene Rate, which is disclosed in the WHO's “Guidelines on Hand Care in Health Care”, based on the manually-determined observed number of opportunities and the automatically-recorded dispenser uses.
U.S. Pat. No. 7,898,407 to Hufton, et al. and U.S. Pat. No. 8,237,558 to Seyed Momen, et al. equate hand hygiene to the use of a dispenser and the dispensing act, further incorporating temporal requirements that are determined between the time of dispensing and a pre-established, acceptable hand-washing time and between the time of dispensing and the entry time into a zone for which hand hygiene is warranted. Alert devices inform HCWs, respectively, that they have washed their hands for the acceptable period of time, e.g., by activating a light-emitting device, or that an acceptable time has passed between the dispensing act and zone entry, e.g., by activating an audible alarm, haptic device, and the like. In each instance, though, the system assumes that the HCWs are actively and vigorously performing hand hygiene until the pre-established time is reached.
Still other patents focus on the hand-washing agent, liquid, solution, and the like used for hand cleansing. For example, U.S. Pat. No. 7,818,083 to Glenn, et al. focuses on whether or not the dispensed liquid is an “authorized solution”, while U.S. Pat. No. 7,375,640 to Plost focuses on the volume of hand-washing agent dispensed. In each instance, once again, the systems and methods assume but cannot ensure that the HCW are actively and vigorously performing hand hygiene for a pre-established time.